The most popular surgical technique for anterior cruciate ligament (ACL) reconstruction is the usage of hamstring grafts. This technique has been popularized through easy graft harvest and graft preparation, as well as consistent good clinical outcomes. This chapter on ACL reconstruction with hamstring graft will go through indications for hamstring ACL reconstruction, graft preparations, different surgical technique modalities, specific complications to hamstring graft ACL reconstruction, and finally, clinical outcomes in comparison to other graft types.